On giving in India

This article sparked something in me enough to write: India's Rich, Open Your Wallets

It goes into how Bill Gates received the Gandhi Prize for Peace, Disarmament and Development on behalf of the Bill & Melinda Gates Foundation, which has poured a $1bn into India. Clearly, not ALL of this money has been put to the best use (see How Bill Gates Blew $258 million in India's HIV Corridor). There are clearly many many things that I could comment on based on my own experience in rural India. I know there are friends of mine who work in global HIV/AIDS from the public health angle, and they too have quite a bit of criticism.

However, my point today is simply the scale of the spending, and the main point that the first article tries to drive home: India's rich need to open their wallets more

While Bill Gates IS super rich and he DOES have a lot of disposable income, there are many billionaires and multi-millionaires in the new 'shining' India. Adjusting for Purchasing Power Parity (PPP), which roughly stands around 4 times the official exchange rate, these people have significant levels of income at their disposal.

Which begets the question - why don't India's wealthy give back more?

The article does an excellent job of presenting many different reasons and opinions on why this is the case. Personally, I have to agree with Tarun Das that there aren't enough outlets for giving. It makes sense that the rich, many of them corporate titans who have made their fortunes by driving hard bargains and results-at-all-costs, would want the same value-for-money and concrete results in their philanthropy. PR at a large scale is not enough simply because it's not NEEDED. Unlike the US, where a corporation's social commitment and community outreach genuinely factor into how well communities accept and support them, and if top talent chooses to work with them, this is really not the case in India. A new middle class is being minted in India, and the only bottomline for talented youth is the financial one at this point. There is no judgement here - it simply is. It makes sense. There is limited choice. The generation before us, my parent's generation, still teaches us the 'conservative', risk-averse way, and reminds us of our 'responsibilities' to the family.

Another favorite line in India is echoed in this article: "Charity begins at home". The typical argument from parents is that yes, it's a good thing to serve and give back, but why don't you serve and give back your immediate family? It's a strong argument, and perhaps relevant to families rising in the socio-economic totem pole. However, for MANY of the families I have encountered, the rest of the nuclear & extended family is doing a good enough job by themselves. Secondly, this is EXACTLY the mindset that we as Indians need to move beyond. It is a question of identity, and how generous you are in your definition of it. Is it enough to be just a particular family from a particular town? Or a particular sub-caste from a particular region? Or a particular caste from a particular state? Or 'high society' vs. 'low society'? Clearly, if you draw this argument out, the only universal truth is to consider yourself as a being of the larger universal, with responsibility towards all, living or human or not. However, the journey from the intellectual answer to spiritual realization is vast, and for most will span multiple lifetimes. Perhaps due to my upbringing, and definitely due to the Indicorps, I choose to look at my identity as that of an Indian, and choose to revel in the idiosyncrasies of all the sub-identities within that. What's not OK to me, and this is gut not intellect speaking, is to limit charity to home. That's the cop-out answer.

For the wealthy to start their charity at an individual/local level, however, makes sense to me. My experience has taught me that we will only climb over brick walls for things that matter to us, that which we personally identify with, where we have 'skin-in-the-game'. And if I choose to be forgiving and be OK with the fact that everyone is at a different point the spectrum of identity, then that's where they should start. For example, the Piramal Foundation, who funded the Grassroots Development Laboratory (GDL), chose to begin its activities in their ancestral home of Bagar, Rajasthan. It's a great place to start, because there is goodwill in the community, people trust your intentions, and you have room to learn from your mistakes. But many a foundations tend to limit themselves to only their ancestral homes, or where they have factories. Foundations that can afford to have massive scale need to step beyond their places of start. I applaud the Piramal Foundation in learning from their experience in Bagar and working towards spreading their work beyond, and I will be keenly following their expansion over the next few years.

There is one 'gap' in my argument here. Beyond the debate of whether charity is good or bad, I see the 'operational' roles of foundations as one of two. First, they can either try to tackle one particular problem or issue e.g. clean water or AIDS or education etc. In this case, once they figure out the solution, they should expand geographically to the greatest extent possible and spread that benefit (yes, greed is good). The other option is that they 'adopt' a particular region. In this case, they should take a holistic view of development in this region, and try to solve EVERY problem that arises. Again, all of this is a theoretical extrapolation, and I completely understand the complexities and ground realities of scaling organizations, particularly those that are mission-based. Looking at it from a business perspective, we can transpose these two options as (1) Producers of goods / services (2) Distributors of goods/services. Piramal Foundation has taken the role of the first, and are thus pushing market-bases / sustainable solutions to particular issues, great example being the expansion of Sarvajal into different territories. I had a chance to visit a foundation in Hyderabad this past April, and I recommended the latter option to them - their 'identity' and 'mission' was much more to help the people where their factories were located, as well as a couple of adopted districts of Andhra Pradesh. But I did push them to think beyond 'good enough' - Yes, 10 free pyaaus (free water stations during India's blistering summer) are great, but why not a 100 or a 1000 to cover all of your area? And also to think holistically about the needs of that area, beyond the projects that were sparked largely by the inspiration of the foundation's team and chairwoman.

All things aside, I strongly believe that India needs its rich to identify with the poor, and open not just their wallets, but also their influence and tenacity to help those in need. Some of the complacency comes from the hangover of the bygone socialist era - 'it's the government's job'. And as much as I applaud Bill Gates generosity, some of it comes from the money being poured in by international aid organizations.

I have a radical thought for India. Why don't we work towards stopping all international aid? And instead find a way, a call-to-action for our own rich? Perhaps one man in India won't part with $1bn, but 10 Indians together can. Will India's rich rise to the occasion if the national identity and self-reliance was called into question? Would ads reminding us of India's 'beggar bowl' image from back in the early 60s do the trick?

A brief history of c-sections

Read:
http://www.nlm.nih.gov/exhibition/cesarean/part4.html

 Legend of Caesar's birth 

Very interesting read on how c-sections came to become prevalent around the world. It is interesting to note that the c-section rate in the US is a above 31%. The WHO mandates that the optimal levels of c-sections in any country should be between 5-15%. This makes logical sense. It is a known fact that 85% of all deliveries are completely normal. That is someone has to just stand there and catch the baby (preferably with clean hands).

I would never discount the pain that women have to go through childbirth (apparently ranked as the most painful human experience, followed at number 2 by testicular torsion). However, undergoing a surgery that has no health benefits for mother or child, and instead a longer recovery period, more chances of infection, and all around increase in cost just doesn’t seem like that good of an idea.

True testament to why public health is such a socio-religio-politico-technologico-economic(o?) probem with no easy solutions.